EBA "Hydroxyurea treatment for sickle cell anemia"

Hydroxyurea treatment for sickle cell anemia 

Sickle-cell disease is one of the most common severe monogenic disorders in the world. It effects nearly 100,000 individuals in the United States and is associated with many acute and chronic complications that require immediate medical attention. It occurs mainly in people of African descent, but is also carried by some persons of Mediterranean descent. Sickle cell disease is a multisystem disease, associated with episodes of acute illness and progressive organ damage. Sickle cells contain an abnormal hemoglobin termed hemoglobin S. There crescent shape makes it difficult for them to pass through capillaries, causing a pileup of cells in small vesicles. The can lead to severe pain from ischemia and may cause infarcts. This article talks about the effects of hydroxyurea in the management of the disease in children and adults. Hydroxyurea is a type of chemotherapy that is used for treatment sickle cell because it lowers the number red blood cells. Hydroxyurea mainly works by reducing the amount HbS made and increasing the amount HbF in the blood. HbF is a natural is a protection against sickle problems. It is very effective as HbF actually carries oxygen around the body releasing it to any sickle blood under stress so preventing the process that causes almost all of the problems in sickle cell disease. According to this evidence based article; Hydroxyurea therapy was consistently associated with overall increases in HbF. In adults and children, decreased rates of hospitalization were reported for patient reciving hydroxyurea therapy. Also Hydroxyurea treatment was associated with decreased mortality in symptomatic patients with SCA compared with patients receiving shorter-term hydroxyurea or no hydroxyurea. The strength of the evidence and serious consequences of frequent VOC provide the basis for strong recommendations for hydroxyurea use in treating adults and children with Sickle cell anemia. 

http://www.bloodjournal.org/content/bloodjournal/124/26/3850.full.pdfh

ISTAN Reflective journal

Reflective ISTAN journal

1. Completed a head to toe assessment. Replaced nasal canula with a non-rebreather mask and monitored the patients O2 levels as the dropped. Planned on doing wound care on patient but he ended up coding because of a critical mistake we made as  a group. We ended up saving our patient in the end though. Documented all of our findings.

2.  I realize even more now, that team work and communication is very important. If had had paid more attention when Kelly asked me to check the insulin, I would have noticed that it was not in the correct syringe and we could have avoided all the chaos.  I feel we remained calm and worked well to in all the chaos.

3. I will make sure I don't miss or forget little things like assessing for allergy and checking our patient temp. W got half way through the simulation and realized we never had a temp for the patient. Also check and make sure our patient has an armband and allergy band.

4. I learned that you must always check your medication several times before administering it and making sure the patient has food near before administering insulin.  I also learned that communication is very important between team members and to communicate clearly with each other.

5. The three things I learned that I put into practice during simulation were med administration, knowledge of therapeutic diets, and CPR.

Hi Nick